NIHR today

NHS research before 2006

Patient-based research in the NHS was conducted and funded through a range of ad-hoc funding programmes and schemes managed by the Department of Health and Social Care to address questions raised by front-line professionals and policy makers. These national programmes included the internationally respected Cochrane Collaboration, the Centre for Reviews and Dissemination (CRD), the Health Technology Assessment (HTA) programme and the Service and Delivery Organisation (SDO).

Although these significantly advanced health research, a range of reviews and reports of health research carried out in the 1990s and early 2000s, including from the Bioscience Innovation and Growth Team and the Academy of Medical Sciences indicated critical challenges to the health research environment in England. These included:

The serious consequences for national health and wealth resulting from inadequate support for clinical research

The need to build a mutually advantageous collaboration between the NHS and the life sciences industry for the benefit of patients and the public

The necessity of creating a public and regulatory environment supportive of health innovation

The requirement for sufficient and sustainable funding.

Creating NIHR through Best Research for Best Health

Professor Dame Sally C Davies FRS FMedSci became Director of Department of Health and Social Care R&D in 2004 and was determined to tackle the issues highlighted in these reports. In 2005, she ran a national consultation to marshal the views of stakeholders around the country on the best way to address the identified challenges that:

money for R&D in the NHS was not focused where it was needed but was locked into historical allocations to NHS Trusts

The NHS R&D programme did not have sufficient capacity or flexibility to generate all the evidence that is crucial to deliver high-quality health services

Research was being eroded from health professionals’ contracts, and researchers were struggling with the increasing burden of regulation and bureaucracy

The NHS was not exploiting its full potential as a research platform to support the country’s international competitiveness.

The national consultation resulted in the Government’s 2005 health research strategy, Best Research for Best Health, and the creation of the National Institute for Health Research in 2006 with its vision ‘to improve the health and wealth of the nation through research’.

The NIHR today

We were established in 2006 to transform research in the NHS. We are a ‘virtual’ organisation which means that although what we do and the research we fund is very real, we are not a corporation or a legal entity or a ‘bricks and mortar’ enterprise in the traditional sense. Rather, we are an overarching entity which collectively represents all publicly-funded research in the NHS. we are now known as ‘the research arm of the NHS’.

Since comprehensive records began in 2009, the total number of patients taking part in, and benefiting from, clinical trials has tripled, rising from under one million to more than five million. In 2014, more than 630,000 people took part in studies hosted by our Clinical Research Network, a 7% increase on the previous year, and 100% of NHS Trusts are now involved in research and are running studies. We established the UK Clinical Trials Gateway to make information about ongoing studies available to patients and the public.

We are the first research organisation in the world to establish a national advisory group, INVOLVE, to make sure the views of patients and the public are an essential part of the processes through which research is identified, prioritised, commissioned, designed, conducted and disseminated. This ensures that NHS, public health and social care research has patient concerns at the heart of all research activities and is relevant, reliable and usable. A recent important development has been investing in young people taking part in research activities through a Young Persons Advisory Group and a Children’s Non Executive Board as they are the future of public participation and involvement in research.

As well as investing in research to help the NHS and care providers meet the major health and social challenges they face, such as long term conditions, inequalities, poverty and ageing, we have responded rapidly to national research priorities, for example, establishing a wide range of activities to meet the Prime Minister’s dementia challenge and the Chief Medical Officer’s concerns over Antimicrobial Resistance. As well as this, a number of themed calls to meet urgent needs have been issued including for Mesothelioma, Pandemic Flu, Compassionate Care, Antimicrobial Resistance, Very Rare Diseases, Long-term Conditions in Childhood, Primary Care, Healthcare Associated Infections and Obesity.

We are committed to making research faster and easier for industry and other funders. The introduction of a 70 day bench-mark for enrolling the first patient into a trial by participating NHS Trusts will ultimately lead to faster translation of research into improved treatments, interventions and services for patients and means more studies are likely to be carried out in this country.

By 2015, nearly £3.5 billion of additional research investment from the Government, charities and the life sciences industry has been attracted through our centres and facilities for experimental medicine in the NHS, with a year on year increase in funding from industry and charities of at least 40%. Over 100 national and international patents have been granted and nearly 200 licensing deals conducted.